For What Are We, Future Health Care Providers, Responsible?

Viewing “Diagnosing Gender” and “The Business of Being Born” enhanced my awareness about what the medical profession has perceived as being their responsibility when providing care for women and transsexual individuals.

According to the films, healthcare providers have assumed the responsibility of making the right choice for these populations, a choice congruent with society’s gender stereotypes. This is evident in both health care providers’ interaction with transsexuals and women undergoing hospitalized pregnancies. Individuals seeking hormone therapy must first receive approval from psychiatrists and then prove their successful sex change to a healthcare provider. Similarly, doctors, a predominantly male population, assume the responsibility of making decisions for pregnant women in regards to medical interventions during birth. In both cases, healthcare providers believe it is their responsibility to make decisions for a group of individuals who either supposedly suffer from a mental disorder or simply do not have the intellectual capacity for deciding for themselves.

This sort of reasoning is of great concern. The responsibility of health care providers should be to present patients with their options and make sure that individuals feel comfortable and safe whether or not their situations are congruent with society’s expectations.

Sources:
The Business of Being Born (2007)
Diagnosis Gender (2011)

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5 Responses to For What Are We, Future Health Care Providers, Responsible?

  1. Anna says:

    I agree with your observations about how norms within the medical establishment have shifted the responsibility for decision-making into the hands of medical practitioners. I’d say this is largely due to the process of medicalization, which allows biomedical doctors and psychologists to exert social control by determining what is normal and exerting those norms on both the “diseased” and “healthy” populations. However, it IS possible to shift away from this, both in terms of the process of giving birth and transgressive gender identities. While both of these areas underwent medicalization during the twentieth century, homosexuality has actually undergone gradual demedicalization, starting with its removal from the DSM-II. This removal was almost entirely due to social advocacy groups organizing and campaigning to have homosexuality’s status as a mental disorder officially questioned and denied. While there is an undeniably long road ahead, the history of homosexuality’s demedicalization demonstrates that the social movements in place for the alteration of the status quo in obstetrics and transsexual health can lead to better patient care and demedicalization where necessary.

  2. laragon14 says:

    I agree with claudiajarenny that in order for doctors and nurses to learn more about natural births and transsexuals and really any other lifestyle choices/conditions/cultural preferences their patients might have, there needs to be a lot more open communication. There are only so many things a textbook can teach you and sometimes the things med/nursing students see on their clinical rotations can be limited. Healthcare should be a collaborative system where the patient is able to communicate openly with his/her healthcare providers in order to make informed decisions and plans regarding his/her care. I also agree that education (or lack of education) is a huge issue, but unfortunately it’s a vicious cycle- the job of the healthcare provider is to educate patients about their conditions or medical options so that the patients are able to make informed medical decisions. If there is no open communication and/or collaboration between the healthcare providers and the patients, then there will be inconsistencies in care. I don’t really know what the solution is…

  3. brossak says:

    I agree with a lot of what claudiajarenny says about the necessity of providing a great depth of education for those people going into the medical profession, because it is not so much an inherent evil or malice (though, as Prof. Lundeen said, there are instances when medical practitioners express their disapproval via mutilating patients) but a lack of preparation.

    I also think blame should be redistributed and not fall solely on medical professionals or their educators but on legislation in the United States. In our lifetimes, we’re seeing a great deal of change in the healthcare system but simultaneously a great deal of legislative resistance to that change. For instance, the movement in Congress, backed by individual businesses, to deny birth control to uterus-possessing (to dodge Spade’s no-no of the term ‘female-bodied’) employees. Several of these objecting institutions are religiously affiliated, and this goes back to a point I brought up in class about the latent (or maybe just blatant) religiosity that maintains a stranglehold on our society.

    While it would be nothing shy of a Herculean task to excise the tumor of Puritanical religious values from the sickly body United States government, I think that is the ultimate solution to the problems presented in both “Business of Being Born” and “Diagnosing Difference”. The labels of ‘man’ and ‘woman’ and their persistence as binary notions stem from the book of Genesis, where they are established in the Creation story as being the two categories of humans and then reinforced through the binary nature of sex in the story of the Flood — animals, two-by-two, one female, one male.

    But, despite the magnitude of the task, I believe it is our responsibility to whittle away at the root of the misconceptions that spur on the injustices we witnessed in the two films and in the course as a whole. Good luck to us, yeah?

    • juanfe93 says:

      I agree with both claudiajarenny and brossak in their focus on blaming the major difficulties with the current state of health care in this country on systemic issues which transcend individual doctors. Education is certainly the root of many of the issues which are discovered when expectant mothers seeking prenatal care and transgendered patients seeking basic medical care walk into clinics and hospitals across the United States. The questions, responses, and advice dispensed by medical practitioners is informed by what they have learned both academically and professionally over time, and both are clearly in serious need of an overhaul.

      brossak is right in pinning much of the blame for healthcare’s current state of affairs on the federal government, which has done relatively little during the past forty years to expand coverage and to ensure that practitioners act in the best interest of patients, save for the Patient Protection and Affordable Care Act of 2010. Much of our legislation during this period has been exclusionary and has limited access to certain elements of care, including the Hyde Amendment of 1977 which eliminated most federal funding for abortions and which made sterilization the only affordable alternative to them for many poor women. Just as important as conducting a close study of legislative ad executive measures enforced by the government, however, is the obscenely high degree of influence which special-interest money has on the lawmaking process.

      Both “Diagnosing Gender” and “The Business of Being Born” point out the immensity of the healthcare industry and the fact that political change is tremendously difficult when essentially every decision made by the government, however minor, affects the amount of profits raked in by the major actors in the industry. As so much is at stake for massive corporations within the pharmaceutical and biomedical sectors of the industry, they are willing and ready to attack any policy changes which they perceive will adversely affect their ability to profit –sometimes at the expense of the patient, notably absent in most of these conversations.

  4. claudiajarenny says:

    I agree with you in that health care providers should be able to aid all those in need of medical assistance regardless of their gender or sexuality. However, I feel that doctors are often portrayed as the bad guys in the many difficulties we as a society face. In both “The Business of Being Born” and “Diagnosing Gender,” doctors are portrayed as the sole perpetrators, which seems a little unfair, considering that not all healthcare providers choose their career based on the large income they receive every year. I think it’s important to stop bashing our current healthcare providers because that won’t make a difference unless. Medical students education in more than just how to give a vaccine on the other hand, is more important. “The Business of Being Born” had an interesting point on how a gynecologist may see about 5 births during their medical education, so can we really blame them for having anxiety issues during a natural birth?

    I think that revolution should be targeted towards education. Just as doctors should receive more education on natural births, women should educate themselves before having a child and look at their different options. I also feel that in order for doctors to learn about transsexuals, transsexuals themselves should be willing to educate those who know very little about them. I understand it must be a tedious thing to go to the doctor and be interrogated about personal matters, but unless transsexuals are more willing to speak, their difficulties with doctors won’t be solved. For every revolution, the pioneers usually go through many difficulties nobody would want to face, but due to their persistance and unity they eventually become heros.

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